Generics Can Reduce Spending on Diabetes Drugs

Findings from a prospective study of diabetes treatments published in the International Journal of Advanced Research in Medicine show that the trend of increasing expenditure can be reduced with the use of generic drugs.¹

Diabetes is the reason for a growing proportion of national health care budget increases worldwide, as the number of patients increases. It is projected to become a main global cause of death and disability within the next 25 years, and experts urge immediate action to find cost-effective treatment strategies.¹

For this reason, investigators in India conducted a prospective study over 6 months to better understand the variations between branded diabetes drugs and generic options, including other complications of type
2 diabetes. Investigators included participants in populations ranging from adolescents to geriatrics and analyzed data on the patients’ reasons for admission, various clinical conditions for which drugs were prescribed, which drugs were prescribed, and cost.¹

A total of 1800 patients were included, ranging from younger than 20 years to age 100 years. Hypertension was noted in approximately 45% of cases, hypothyroidism in 2% of participants, and peripheral neuropathy in 5%. Diabetic retinopathy and lower limb cellulitis were both observed in 1% of cases.¹

In a price comparison for the most commonly prescribed branded and generic drugs, the investigators found significant savings for patients prescribed the generic options. For example, a generic metformin 50 mg had a 40% savings compared with the branded version. This was the lowest savings, however, with differences as high as 75.8% for the other generics.¹

The combination of vildagliptin 50 mg and metformin 500 mg had a 49.6% savings when the generic was administered versus the branded version, and glimepiride 2 mg had a savings of 59.5%. Generic versions of the combination glimepiride 1 mg or 2 mg and metformin 500 mg were between 70% and 71.7% less expensive than their branded counterparts, and gliclazide 80 mg plus metformin 500 mg had the greatest savings at 75.8%.

Savings such as these can have a massive impact both on national health care expenditures and on patients. Because of its chronic nature and the frequent occurrence of comorbidities, the paper authors said that medications account for a large portion of the direct cost of diabetes.¹

Other research has found that prescribing generic or preferred medications can improve adherence for patients with chronic conditions. The results of a study published in JAMA Internal Medicine showed that patients who initiated therapy with generic and preferred medications had 62% and 30% greater odds, respectively, of achieving adequate adherence compared with patients who received nonpreferred medications.²

Prescribing generic drugs is one way to lower medication costs in chronic care, but the biggest barrier to generic drug adoption is patient and physician skepticism about their efficacy and quality. Policymakers can play a major role in encouraging adoption, with policies designed to encourage use of generics and increased education for prescribers.

Patients with diabetes spend a large percentage of income on managing their disease, according to the study authors. In addition to minimizing expenditures for larger health systems and these patients individually, dispensing generic medications whenever possible can improve medication adherence and disease outcomes.

REFERENCES

Netaji N, Ravi PL. Increasing expenditure on diabetic drugs can be reduced by using generic drugs. Intl J Adv Res Med. 2021;3(1):411-414. doi:10.22271/27069567.2021.v3.i1g.173

Shrank W, Hoang T, Ettner SL, et al. The implications of choice: prescribing generic or preferred pharmaceuticals improves medication adherence
for chronic conditions. Arch Intern Med. 2006;166(3):332-337. doi:10.1001/ archinte.166.3.332